RESUMEN
Gastric emptying studies were performed on 11 nondiabetic Mexican-Americans and 11 nondiabetic non-Hispanic whites following ingestion of 450 mL beer. Plasma glucose, serum insulin, and serum alcohol levels were measured in the fasting state and at 7, 15, 30, 45, and 60 minutes following ingestion of the beer. The area under the gastric emptying curve was significantly larger for non-Hispanic whites compared with Mexican-Americans (P = .0492), indicating that Mexican-Americans had faster stomach emptying. Partial correlation coefficients (adjusted for ethnicity, gender, age, and body mass index [BMI]) showed the gastric half-emptying time was inversely related to the incremental levels of glucose (r = -.709, P = .0010) and alcohol (r = -.650, P = .0035). The faster the rate of gastric emptying of beer, the higher the glucose and alcohol levels. There were no significant correlations between insulin and the rate of gastric emptying. The caloric emptying rate for the beer was much more rapid than previously reported for other liquid meals.
Asunto(s)
Cerveza , Vaciamiento Gástrico , Americanos Mexicanos , Población Blanca , Adulto , Glucemia/análisis , Etanol/sangre , Etnicidad , Femenino , Humanos , Insulina/sangre , Masculino , Valores de ReferenciaRESUMEN
Mexican Americans, a group at high risk for type II diabetes mellitus, have higher postprandial insulin and glucose levels when compared to non-Hispanic whites. A rapid rate of gastric emptying contributes to an increased rate of nutrient absorption and subsequent greater elevation of postprandial glucose and insulin levels. A more rapid rate of gastric emptying and hyperinsulinemia have been observed in patients with recently diagnosed type II diabetes mellitus. In this study, we examined whether Mexican Americans have a more rapid rate of gastric emptying than non-Hispanic whites. Gastric emptying studies were performed on 32 nondiabetic Mexican Americans and on 31 nondiabetic non-Hispanic whites. The rate of gastric emptying following a liquid glucose meal was measured. Serum insulin, plasma glucose, and GIP levels were measured in fasting and postprandial blood samples collected at 15-min intervals for 2 hr. Adjusting for age, body mass index, and gender, the gastric half-emptying time of a glucose meal was significantly (P < 0.05) more rapid for the Mexican American subjects (56.5 +/- 3.4 min) compared to the non-Hispanic white subjects (66.4 +/- 3.5 min). Nondiabetic Mexican Americans empty a liquid glucose meal more rapidly from their stomachs than nondiabetic non-Hispanic whites. Rapid gastric emptying is associated with hyperinsulinemia as a normal physiologic response to increased nutrient availability. The rapid gastric emptying observed in nondiabetic Mexican Americans is associated with hyperinsulinemia and could be a contributing factor for the increased risk of obesity and type II diabetes in this population.
Asunto(s)
Diabetes Mellitus Tipo 2/etnología , Vaciamiento Gástrico/fisiología , Insulina/sangre , Americanos Mexicanos , Glucemia/análisis , Femenino , Polipéptido Inhibidor Gástrico/sangre , Glucosa , Humanos , Hiperinsulinismo/etnología , Incidencia , Masculino , México/etnología , Obesidad/etnología , Factores de Riesgo , Azufre Coloidal Tecnecio Tc 99m , Población BlancaRESUMEN
The occurrence of human nocardiosis is increasing in both immunocompetent as well as immunosuppressed patients. We report three rare cases of primary lymphocutaneous Nocardia brasiliensis infection. The mode of inoculation in each case was that of a puncture wound that occurred 1-3 wk prior to the development of the clinically apparent infections. The original clinical diagnosis was erroneous in each case. A review of 16 previously reported cases is presented as well as a discussion of appropriate medical therapy.
Asunto(s)
Enfermedades Linfáticas/microbiología , Nocardiosis/diagnóstico , Enfermedades de la Piel/microbiología , Adulto , Anciano , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Femenino , Humanos , Enfermedades Linfáticas/diagnóstico , Masculino , Pruebas de Sensibilidad Microbiana , Nocardia/efectos de los fármacos , Nocardia/aislamiento & purificación , Nocardiosis/tratamiento farmacológico , Enfermedades de la Piel/diagnósticoRESUMEN
To investigate the acute physiologic effects of external expiratory resistance on lung function in extubated neonates recovering from respiratory disease, lung mechanics, respiratory patterns, and functional residual capacity were measured in ten neonates dueing a control period and immediately after application of an external expiratory resistance of 30 cm H2O/l/second via a face mask. Following application of EER, mean FRC increased by 40.8% (P less than 0.05). The work of breathing was significantly increased after the EER was applied; there was also a significant increase in measured expiratory resistance and a decrease in inspiratory-expiratory time ratio. The change in lung volume was rapid, requiring less than five seconds for the new end-expiratory level to be reached. Dynamic lung compliance, inspiratory resistance, and respiratory rate did not change during any phase of the study. The application of external expiratory resistance may have potential therapeutic value by increasing lung volume in infants recovering from respiratory disease.
Asunto(s)
Enfermedades del Recién Nacido/fisiopatología , Respiración con Presión Positiva , Enfermedades Respiratorias/fisiopatología , Resistencia de las Vías Respiratorias , Flujo Espiratorio Forzado , Capacidad Residual Funcional , Humanos , Recién Nacido , Intubación Intratraqueal/efectos adversos , Rendimiento Pulmonar , Mediciones del Volumen Pulmonar , Respiración , Enfermedades Respiratorias/terapia , Trabajo RespiratorioRESUMEN
Fourteen intubated infants recovering from neonatal respiratory disease had arterial blood gases and lung mechanics measured in the supine position and in two variants of the prone position. Prone positioning resulted in significant increases in mean (+/- SEM) arterial oxygen tension (Pa(o2 70.4 +/- 2.5 to 81.1 +/- 4.4mm Hg), dynamic lung compliance (1.7 +/- 0.24 to 2.55 +/- 0.37 ml/cm H2O),and tidal volume (8.6 +/- 1.0 to 10.5 +/- 1.2 ml) when all prone values were compared to supine values. Prone positioning with the abdomen protruding freely, when compared to all supine values, was associated with significantly increased dynamic lung compliance and tidal volume. Values for prone-abdomen free were not significantly different from values for prone-abdomen restricted. This suggests that there are clinical benefits from prone positioning in neonates recovering from respiratory disease.
Asunto(s)
Enfermedades del Recién Nacido/fisiopatología , Rendimiento Pulmonar , Enfermedades Pulmonares/fisiopatología , Oxígeno/sangre , Postura , Equilibrio Ácido-Base , Sangre , Femenino , Humanos , Concentración de Iones de Hidrógeno , Recién Nacido , Masculino , Volumen de Ventilación PulmonarRESUMEN
To investigate physiologic alterations in respiratory function associated with chest physiotherapy, arterial blood gases, respiratory patterns, lung mechanics, and functional residual capacity were measured in 13 neonates (weights 1.25 to 3.20 kg) during the control period, after vibration of the chest and suctioning, after hyperventilation, and two hours after suctioning. Compared to control values, mean PO2decreased significantly after suctioning to 43 mm Hg and increased significantly after hyperventilation to 78 mm Hg. There was a significant decrease in inspiratory resistance and a trend toward decrease in expiratory resistance after suctioning, with return to control levels after hyperventilation. Respiratory rate increased significantly after suctioning. Functional residual capacity, dynamic lung compliance, and tidal volume, as well as PCO2 and base excess, were not changed appreciably throughout the protocol. Because of potentially severe hypoxemia, this study suggests that suctioning and hyperventilation are not warranted on a routine basis in infants recovering from respiratory diseases.